Zollinger-Ellison syndrome revisited: Diagnosis, biologic markers, associated inherited disorders, and acid hypersecretion

被引：54

作者：

Gibril F. ^{[1
]}

Jensen R.T. ^{[1
]}

机构：

[1] Digestive Diseases Branch, National Inst. of Diabetes/Digestive, National Institutes of Health, Bethesda, MD 20892-1804

来源：

Current Gastroenterology Reports | 2004年 / 6卷 / 6期

关键词：

Gastrin Level; Gastrinoma; Pancreatic Endocrine Tumor; Gastric Carcinoid; Acid Hypersecretion;

D O I：

10.1007/s11894-004-0067-5

中图分类号：

学科分类号：

摘要：

Despite general awareness of Zollinger-Ellison syndrome (ZES) by most physicians and more than 3000 articles written about it since 1955, the diagnosis of ZES is still delayed for a mean of 5 years. Recent studies show it is being delayed even more with the widespread use of proton pump inhibitors. A number of tumor markers, in addition to assessing serum gastrin, such as chromogranin A, neuron-specific enolase, and subunits of chorionic gonadotropin, have been proposed for use in either the diagnosis of pancreatic endocrine tumors, such as gastrinomas, or for assessment of tumor extent and growth. In this article important recent insights into the diagnosis of ZES as well as the clinical usefulness of assessing tumor markers for diagnosis and determination of disease extent and growth are discussed. Approximately 25% of ZES cases are due to multiple endocrine neoplasia type 1 (MEN1). A number of important studies in this group of patients are also reviewed. Finally, almost every patient with ZES has marked gastric acid hypersecretion, and its current treatment as well as the long-term possible side effects are reviewed briefly. Copyright © 2004 by Current Science Inc.

引用

页码：454 / 463

页数：9

共 71 条

[1]

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[2]

Roy P., Venzon D.J., Shojamanesh H., Et al., Zollinger-Ellison syndrome: Clinical presentation in 261 patients, Medicine, 79, pp. 379-411, (2000)

[3]

Delle Fave G.F., Frati L., Jensen R.T., Advances in digestive endocrine tumours, Ital. J. Gastroenterol. Hepatol., 31, (1999)

[4]

Corleto V.D., Delle Fave G., Jensen R.T., Molecular insights into gastrointestinal neuroendocrine tumors: Importance and recent advances, Dig. Liver Dis., 34, pp. 668-680, (2002)

[5]

Norton J.A., Jensen R.T., Current surgical management of Zollinger-Ellison syndrome (ZES) in patients without multiple endocrine neoplasia-type 1 (MEN1), Surg. Oncol., 12, pp. 145-151, (2003)

[6]

Norton J.A., Jensen R.T., Resolved and unresolved controversies in the surgical management of patients with Zollinger-Ellison syndrome, Ann. Surg., (2004)

[7]

Jensen R.T., Carcinoid and pancreatic endocrine tumors: Recent advances in molecular pathogenesis, localization, and treatment, Curr. Opin. Oncol., 12, pp. 368-377, (2000)

[8]

Corleto V.D., Annibale B., Gibril F., Et al., Does the widespread use of proton pump inhibitors mask, complicate and/or delay the diagnosis of Zollinger-Ellison syndrome?, Aliment. Pharmacol. Ther., 15, pp. 1555-1561, (2001)

[9]

Jensen R.T., Gardner J.D., Gastrinoma, The Pancreas: Biology, Pathobiology and Disease, pp. 931-978, (1993)

[10]

Jensen R.T., Management of the Zollinger-Ellison syndrome in patients with multiple endocrine neoplasia type 1, J. Intern. Med., 243, pp. 477-488, (1998)

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